Screening and Test Evaluation Program, Sydney School of Public Health, Edward Ford Bldg (A27), University of Sydney, NSW 2006, Australia.
Prev Med. 2011 Sep;53(3):144-6. doi: 10.1016/j.ypmed.2011.06.013. Epub 2011 Jun 24.
In current medical literature, mammography and other cancer screening programs are subject to controversy because of debate about the magnitude and nature of the benefits and harms. This paper discusses the issues around informed choice for women considering breast screening.
We discuss qualitative and quantitative studies of women's attitudes to breast screening and informed choice.
Women view breast screening as a way of avoiding potential regret, and reassurance from normal results is highly valued. Screening participants acknowledge anxiety about false positives but awareness regarding potential overdetection of indolent breast cancer is minimal, and research is needed to assess how better understanding of screening downsides may affect women's views. In any case, weighing up screening advantages and disadvantages is sensitive to personal preferences.
Communicators have an ethical obligation to make balanced information available to women, which is flexible enough to respond to the level of detail and involvement desired by each individual. Many women want to know more and to participate more actively in screening decisions. Techniques have been developed to present balanced information and support individual decision making in ways that are accessible and empowering for the wider community. Evaluations of breast cancer screening must integrate clinical data with evidence on the perspectives of women themselves.
在当前的医学文献中，乳腺 X 线摄影术和其他癌症筛查项目备受争议，原因是关于其益处和危害的程度和性质存在争议。本文讨论了女性考虑乳腺筛查时知情选择的相关问题。
我们讨论了女性对乳腺筛查和知情选择的态度的定性和定量研究。
女性将乳腺筛查视为避免潜在遗憾的一种方式，对正常结果的保证非常重视。筛查参与者承认对假阳性的担忧，但对潜在惰性乳腺癌过度检测的认识很少，需要研究如何更好地了解筛查的缺点可能会影响女性的观点。在任何情况下，权衡筛查的利弊都对个人偏好很敏感。
传播者有道德义务向女性提供平衡的信息，这些信息足够灵活，可以满足每个个体所需的详细程度和参与程度。许多女性希望了解更多信息，并更积极地参与筛查决策。已经开发出了一些技术，可以以一种易于理解和赋权的方式呈现平衡的信息，并支持更广泛群体的个体决策。乳腺癌筛查的评估必须将临床数据与女性自身观点的证据相结合。
